Equity in healthcare access and service coverage for older people: a scoping review of the conceptual literature

Abstract

There is currently no global review of the conceptual literature on the equity of healthcare coverage (including access) for older people. It is important to understand the factors affecting access to health and social care for this group, so that policy and service actions can be taken to reduce potential inequities. A scoping review of published and grey literature was conducted with the aim of summarising how health and social care service access and coverage for older people has been conceptualised. PubMed, MEDLINE, PsycINFO, CINAHL, Web of Science, SciELO, LILACS, BIREME and Global Index Medicus were searched. Selection of sources and data charting were conducted independently by two reviewers. The database searches retrieved 10 517 citations; 32 relevant articles were identified for inclusion from a global evidence base. Data were summarised and a meta-framework and model produced listing concepts specific to equitable health and social care service coverage relating to older people. The meta-framework identified the following relevant factors: acceptability, affordability, appropriateness, availability and resources, awareness, capacity for decision-making, need, personal social and cultural circumstances, physical accessibility. This scoping review is relevant to the development and specification of policy for older people. It conceptualises those factors, such as acceptability and affordability, that affect an older person’s ability and capacity to access integrated, person-centred health and social care services in a meaningful way. These factors should be taken into account when seeking to determine whether equity in service use or access is being achieved for older people.

Enhancing Telehealth Competency: Development and Evaluation of Education Modules for Older Adults

“…Specifically, stakeholders shared strategies that would increase the accessibility of the materials as well as ways to address privacy concerns within the modules. Accessibility of training materials and resources to promote competence of telehealth is critical to reducing disparities to health service access experienced by this population ( Carroll et al, 2022 ) and improving client experiences as part of the Quadruple Aim ( Bodenheimer & Sinsky, 2014 ). Novel findings from this study also showed that online training materials, when adapted to meet older adults’ needs, may be efficacious in increasing their perceived competence and confidence to use telehealth.…”

“…Despite these barriers, older adults express a willingness to adopt telehealth to access services that would facilitate independent living ( Edwards et al, 2014 ; Qin, 2022 ; Vaportzis et al, 2017 ). Targeted and accessible training is critical for adoption among this population ( Carroll et al, 2022 ).…”

Enablers and Barriers of Accessing Health Care Services among Older Adults in South-East Asia: A Scoping Review

“…The availability and accessibility of healthcare services may not be sufficient to encourage older people to access them. Moreover, older people should not be treated as a homogeneous group [ 39 ], as factors that act as enablers or barriers for a particular individual may not apply to other older persons.…”

Older People’s Understandings and Experiences of Using Health and Social Care Services under COVID-19 Lockdown Restrictions in Aotearoa, New Zealand

“…Access to services under COVID-19 restrictions matters because older people worldwide tend to have disadvantaged access to health and social care services even prior to the pandemic [10]. Disadvantage relates to the ways that health and social care services operate in a way that privileges younger populations, for example, by focusing on curative, rather than recovery and long-term, care [11].…”